Individual
SAMUEL GRAY DEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3100 MACCORKLE AVE SE, SUITE 602, CHARLESTON, WV 25304-1223
(304) 388-5120
(304) 388-5125
Mailing address
3100 MACCORKLE AVE SE STE 602, CHARLESTON, WV 25304-1231
(304) 388-5280
(304) 388-5291
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2176
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010649
—
WV
01
—
P01087428
RAILROAD MEDICARE
WV
Enumeration date
04/06/2007
Last updated
12/01/2025
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